This is a Shannon award providing partial support for the research projects that fall short of the assigned Institute's funding range but are in the margin of excellence. The Shannon award is intended to provide support to test the feasibility of the approach; develop further tests and refine research techniques; perform secondary analysis of available data sets; or conduct discrete projects that can demonstrate the PI's research capabilities or lend additional weight to an already meritorious application. The abstract below is taken from the original document submitted by the principal investigator. DESCRIPTION (Adapted from Investigator's abstract): Although many other factors may contribute to the excess morbidity and mortality from asthma which is seen in the inner city, strong epidemiologic evidence now points to cockroach allergen exposure as an important risk factor. Not only is cockroach infestation predominantly a problem of the inner city, but it is one that potentially can be changed. The investigators have been able to reduce indoor cockroach allergen levels in pilot studies and now propose to conduct an intervention trial to test the hypothesis that reducing home environmental cockroach will improve chronic asthma control in children. The investigators will recruit 100 children aged 6-12 years with moderately severe asthma who have a positive skin test to cockroach, who are living in a home which is infested with cockroaches and which has Bla g I concentration of greater than 2 U/gm, who do not have a furred pet and whose families own a working vacuum cleaner. During a baseline period of 4 months, children will be evaluated and maintain a diary of symptoms, peak expiratory flow rate (PEFR) and medication use. They will visit once a month to evaluate their diary, to confirm medication use by weighing beta adrenergic inhalers to measure PEFR and to receive education regarding asthma self management and allergen avoidance. The investigators will visit their home to inspect and collect settled dust for cockroach (Bla g I and II) allergen analysis. After completing the baseline period, 50 children will be randomized to roach intervention, and 50 to control intervention for a 6 month trial. Roach intervention will consist of extermination from a professional pest control company combined with mattress covers and monthly cleaning by professional home cleaners. Control intervention will consist of monthly cleaning and mattress covers. Cleaning technicians will also monitor live roach population with passive traps and inspection as well as collect settled dust for allergen analysis. Families will maintain diaries and will be evaluated at clinic visits every 2 months during the 6 month period. Children will perform a methacholine inhalation challenge before and after intervention. The effect of environmental intervention in the 2 groups will be compared in terms of the primary clinical variable, beta adrenergic medication use, and the primary process variable, settled dust cockroach allergen concentrations. Secondary variables, including symptom scores, PEFR, acute care visits, school loss, cockroach numbers and methacholine responsiveness will also be compared.